Apps Assignment Example | Topics and Well Written Essays - 1500 words - 1

Apps - Assignment Example These applications can be instrumental transforming the healthcare environment by facilitating various capabilities for the diagnosis of diseases as well as helping people to monitor their health and vital statistics apart from affording them an easy platform for coordinating all their healthcare related activities. The areas where mobile applications can be used in the healthcare field include, but are not limited to, diagnosis of diseases, drug reference, medical calculator, searching medical literature, clinical communication, Hospital Information System for patients, â€Å"general healthcare applications,† learning tool for medical and nursing students, various utilities for patients etc (Mosa et al 8). Mobile apps are especially useful in the case of diseases like blood pressure as they offer the leverage to â€Å"control the inflation and deflation of a blood pressure cuff through a mobile platform† (Mobile Medical Applications 14). Evidence further suggests that personalizing the health monitoring system will â€Å"significantly improve† the possibility of early detection of cardio vascular diseases (CVDs), including blood pressure (Mena et al 4). Besides, ambulatory blood pressure (ABP) monitoring will also facilitate â€Å"accurate diagnosis† as well as easy evaluation of response to treatment (4). Mobile applications provide an appropriate platform for ABP and by using them in transportable devices such as mobile phones and PDAs etc people can effectively monitor the onslaught as well as response to the treatment of hyper tension. In order to test the above hypothesis, the researcher has focused on conducting a study on people from Florida State especially those from the cities such as Miami and Orlando. Since the treatment of blood pressure is to be undertaken over a long period, the study spanned over a term of three years from 2010 to 2013 to

History of International Human Resource Management

History of International Human Resource Management Up until the 1960s, even firms operating internationally maintained organizational structures with centralised technical and managerial resources, manufacturing ability, and the access to and control of the capital (Doz Prahalad 1981). As exports increased, it was seen as more attractive to establish sales subsidiaries in other countries, often staffing them with skilled personnel from the home country. These expatriates had the necessary product knowledge, and could even initiate local manufacture, but also had a perceived primary loyalty to the home company and country culture. Unfortunately, this was also an era of convergence thinking (usually towards the dominant U.S. culture), with sometimes lamentably littleattention being given to national sensitivities and cultural beliefs and behaviours With the developing internationalisation of many firms in the late 1960s and early 1970s, companies established overseas plants and entered joint ventures with foreign affiliates. Firms sought commercial success through moving closer to their customers by employing more host-country nationals. In some situations, they aimed at being perceived more as local rather than foreign, for various reasons. In the 1990s, not only has the practice of IHRM become more sophisticated, but research into its policy and practice has become established. It has a developing body of research and practice which is regularly considered at dedicated conferences, and published in general management as well as HRM journals. Increasingly, international HRM is being taught in university faculties of business management courses, and management MBA graduates, as well as graduates in HRM, are now more frequently aware of the issues involved, and the functions of HRM in an international context. International human resource management What an HR manager does in a multinational corporation varies from firm to firm. It also depends on whether the manager is located in a global corporations headquarters or onsite in a foreign subsidiary. What is IHRM? Actually, it is not easy to provide a precise definition of international human resource management (IHRM) because the mission of an HR manger in a multinational corporation (MNC) varies on a large scale. Generally speaking, IHRM is the effective utilization of human resources in a corporation in an international environment. The term IHRM in most studies has traditionally focused on the area of expatriation (Brewster and Harris, 1999) Broadly defined, international human resource management (IHRM) is the process of procuring, allocating, and effectively utilising human resources in a multinational corporation. If the MNC is simply exporting its products, with only a few small offices in foreign locations, then the task of the international HR manager is relatively simple. However, in global firms human resource managers must achieve two somewhat conflicting strategic objectives. First, they must integrate human resource policies and practices across a number of subsidiaries in different countries so that overall corporate objectives can be achieved. At the same time, the approach to HRM must be sufficiently flexible to allow for significant differences in the type of HR policies and practices that are most effective in different business and cultural settings. This problem of balancing integration (control and coordination from HQ) and differentiation (flexibility in policies and practices at the local subsidiary level) have long been acknowledged as common dilemmas facing HR and other functional managers in global corporations. Although some argue that IHRM is not unlike HRM in a domestic setting, others point out that there  are significant differences. Specifically compared with domestic HRM, IHRM (I) encompasses more functions, (2) has more heterogeneous functions, (3) involves constantly changing perspectives, (4) requires more involvement in employees personal lives, (5) is influenced by more external sources, and (6) involves a greater level of risk than typical domestic HRM. When compared with domestic human resource management, IHRM requires a much broader perspective on even the most common HR activities. This is particularly so for HR managers operating from a MNCs headquarters (HQ). The number and variety of IHRM activities are daunting. International HR managers must deal with issues as varied as international taxation; international relocation and orientation; various other administrative services for expatriates; selecting, training and appraising local and international employees; and managing relations with host governments in a number of countries around the world. Even when dealing with one particular HR function area such as compensation, the international HR manager is faced with a great variety of national and international pay issues. For example, while dealing with pay issues, the HQ-based HR manager must coordinate pay systems in different countries with different currencies that may change in relative value to one another over time. An American expatriate in Tokyo who receives a salary of $100,000 may suddenly find the buying power of that salary dramatically diminished if the Japanese yen strengthens in value relative to the US dollar. A US dollar purchased 248 yen in 1985, but less than 110 yen in 2000. In the case of fringe benefits provided to host company employees, some interesting complications might arise. For instance, it is common in the United States to provide health insurance benefits to employees and the employees family, which usually means spouse and children. In some countries however, the term family may include a more extended group of relatives-multiple spouses, aunts, uncles, grandparents, nephews, and nieces. How does the firms benefit plan deal with these different definitions of family? A final aspect of the broader scope of IHRM is that the HQ-based manager deals with employee groups that have different cultural backgrounds. The HQ manager must coordinate policies and procedures to manage expatriates from the firms home country (parent country nationals, PNCs), host-country nationals (HCNs), as well as third country nationals (TCNs, e.g. a French manager working for an American MNC in the firms Nigerian subsidiary) in subsidiaries around the world. Although such issues are important for the HQ-based manager, they are also relevant to the HR manager located in a subsidiary. This manager must develop HR systems that are not only acceptable to the host country but also compatible with company-wide systems being developed by his or her HQ-based counterpart. These policies and practices must effectively balance the needs and desires of local employees, PCNs and TCNs. It is at the subsidiary level that the increased involvement of IHRM in the personal lives of employees becomes particularly apparent. It is not unusual for subsidiary HR managers to be involved in arranging housing, healthcare, transportation, education, and recreation activities for expatriate and local staff. IHRM activities are also influenced by a greater number of external forces than are domestic HR activities. The HQ-based manager may have to set equal employment opportunity (EEO) policies that meet the legal requirements of both the home country and a number of host countries. Because of the visibility that foreign firms tend to have in host countries (especially in developing countries), subsidiary HR managers may have to deal with ministers, other political figures, and a great variety of social and economic interest groups than would normally be encountered in a purely domestic HRM. Excerpt from Human Resource Management by Cynthia D Fisher, Lyle F Schoenfeldt, James B Shaw. Published by Biztantra

Bowen Family Therapy Essay -- Psychology

Introduction Murray Bowen was born in 1913 in Tennessee and died in 1990. He was the oldest child in a large cohesive family. He trained as a psychiatrist and originally practiced within the psychoanalytic model. In his practice he involved mothers in the investigation of schizophrenic patients. He thought that the cause of schizophrenia begun in mother-child symbiosis which created an anxious and unhealthy attachment. His devotion to his own psychoanalytic training was set aside after his move to the National Institute of Mental Health (NIMH) in 1954 as he begun to shift from an individual focus to an appreciation of the dimensions of families as systems. He began to include more family members in his research and psychotherapy with schizophrenic patients. In 1959, he moved to Georgetown University and established the Georgetown Family Centre where he was a director until his death. It was here where his theory was extended to less severe emotional problems (Nichols & Schwartz, 2004, p. 120). In 1962, he undertook detailed research into families across several generations. Rather than developing a theory about pathology, Bowen focused on what he saw as the common patterns of all ‘human emotional systems’. With such a focus on the qualitative similarities of all families, Bowen was known to say frequently that there is a little schizophrenia in all of us. In 1966, Bowen published a presentation of his developing ideas and around the same time, used his concepts to guide his intervention in an emotional crisis in his own extended family which he described as a spectacular breakthrough (Kerr & Bowen, 1988). Theory concepts Bowen introduced eight interlocking concepts to explain family development and functioning. ... ...stems.ca /bowen theory and research/bowen theory Bowen, M. (1971). Family therapy and family group therapy. In Comprehensive group psychotherapy, H. Kaplan and B. Sadock, eds. Baltimore: Williams & Wilkins. Bowen, M. (1978). Family therapy in clinical practice. NY and London, Jason Aroson Brown, J. (1999). Australian and New Zealand Journal of Family Therapy (ANZJFT) 20(2), 94-103. Retrieved : http://www.familysystemstraining.com/papers/bowen-illustration-and-critique.html Guerin, P.J. (1976). Family therapy: Theory and practice. New York: Gardner Press Kerr, M., & Bowen, M. (1988). Family evaluation. New York: Norton Nichols, M.P. & Schwartz, R.C. (2004). Family therapy: Concepts and methods (6th ed.). Pearson Education Inc. US Rabstejnek, C. (2010). Family Systems and Murray Bowen theory. Web. 13 August 2015. http://www.houd.info /bowenTheory.pdf

Occurrence Of Malnutrition In Children Health And Social Care Essay

The childhood period is the most of import phase for the overall development during the lifetime. Brain and biological development takes topographic point at this phase Muller and Jahn, 2009. These developments are influenced by sufficient of stimulation and nutrition, and this development affects of build, the immune system, knowledge, every bit good as societal and emotional growing ( Handal et al. 2007 ) . Such development helps to guarantee that each kid reaches his or her possible and is a productive member of society ( Uthman, 2009 ) . When kids waste their early old ages with a decreased sum of motivation, or a less emotionally and physically encouraging environment encephalon development is affected and leads to cognitive, societal and behavioural holds. Many factors can disrupt early kid development such as malnutrition ( WHO, 2009 ) . The nutritionary position of kids is a important presentation of wellness and development ; it is non merely a representation of past wellnes s but an of import index of future wellness ( Subramanyam et al. 2010 ) . Malnutrition is one of the of import wellness jobs throughout the universe, peculiarly in developing states ( Sarifzadeh et al. 2010 ; Hioui et Al. 2010 ) . Malnutrition is an of import public wellness job because it leads to increased hazard of decease from infective diseases, more terrible infections and a high cause of mortality, and making extra psychosocial loads ( Jesminet al. 2011 ) . Malnutrition is a status doing scrawny growing, scraggy, and blowing ( Faber et al. 2010 ; Subramanyam et Al. 2010 ; Uthman, 2009 ; Kandala et Al. 2011 ; Janevic et al.2010 ) , inadequacy of protein, energy and other foods and instability between the foods the organic structure needs and the foods it receives ( Muller and Jahn, 2009 ) . Malnutrition can be detected by anthropometric measurings were height-for-age ( HAZ ) , weight-for-age ( WAZ ) and weight-for-height ( WHZ ) is measured against a set of WHO child and growing criterions and NCHS/WHO mention ( Hioui et al. 2010 ; Lesiapeto et Al. 2010 ) . Malnutrition degrees are still high in developing states around the universe ( Sunil, 2009 ) , an estimated cachexia 9.8 % , scraggy 17.9 % and stunting 29.2 % ( WHO, 2009 ) , included Indonesia. Harmonizing to the WHO ‘s reported prevalence of malnutrition in kids under five old ages of age during the twelvemonth 2007 in Indonesia 19.6 % are scraggy, 40.1 % stunted, 14.8 % showed cachexia and 11.2 % were overweight. Many factors can be associated with the happening of malnutrition in kids. For illustration, inadequate wellness services and an unhealthy environment ( Schoeman et al. 2010 ; Hioui et Al. 2010 ) , socio-cultural environments ( Mashalet al.2008 ; Noughani & A ; Bagheri, 2010 ) , socioeconomic, maternal, and child factors ( Lesiapeto et al.2010 ; Hasselman et al.2006 ) , and socio-demographic factors ( Phengxay et al. 2007 ; Handal et al. 2007 ) . An apprehension of the most of import causes of malnutrition is imperative to be identified and an analysis would so bespeak more specii ¬?cally the type of policies, wellness plans and where resources should be directed to right the root causes of inequality in childhood malnutrition ( Lesiapetoet al. 2010 ; Uthman, 2009 ) .Statement of the jobThere are many factors that can act upon the happening of malnutrition in kids under five old ages of age are child factors, female parent factors, and family factors.Research aimThe chief aim in this research is to happen out the major factors act uponing the happening of malnutrition in kids under five old ages of age.Chapter IIReview of Relevant LiteratureDefinitionMalnutrition is a status manifested by stunting, being scraggy, and blowing if his/her tallness for age ( HAZ ) , weight for age ( WAZ ) and weight for tallness ( WHZ ) z-score was more than two standard divergences ( SDs ) below the mention median ( Lesiapeto et al. 2010 ; Sub ramanyam et Al. 2010 ; Uthman, 2009 ; Kandala et Al. 2011 ; Janevic et Al. 2010 ) , inadequacy of protein, energy and other foods and instability between the foods the organic structure needs and the foods it receives ( Muller, 2009 ) . Stunting is characterized by shortness-for-age or step of additive growing deceleration, an index of chronic malnutrition and calculated by comparing the height-for-age of a kid with a mention population of well-fed and healthy kids ( Muller and Jahn, 2009 ; Sunil, 2009 ) . Wasting is a contemplation of a recent and terrible procedure that has led to significant weight loss, normally associated with famishment and/or disease ; calculated by comparing weight-for-height of a kid with a mention population of well-fed and healthy kids ; indicates the acute degree of malnutrition or the current nutritionary position of kids and frequently used to measure the badness of the exigencies because it is strongly related to mortality ( Muller and Jahn, 2009 ; Sunil, 2009 ) . Underweight is measured by comparing the weight-for-age of a kid with a mention population of well-fed, composite step that indicates both acute and chronic malnutrition in kids ( Muller and Jahn, 2009 ; Sunil, 2009 ) .Factors act uponing the happening of malnutritionBase on the literature reexamine the factors act uponing the happening malnutrition in kids under five old ages of age are ; Child factors The kid factors are act uponing the happening of malnutrition are suckling, age of the kid, size at birth, sex of kid, hazardous birth interval ( Uthman, 2009 ) . Mother factors The female parent factors act uponing the happening of malnutrition are female parent ‘s age, female parent ‘s business, female parent ‘s instruction, and matrimonial position ( Uthman, 2009 ) . Family factors The family factors act uponing the happening of malnutrition are topographic point of abode, part, house sanitation, H2O beginning, and figure of kids in the house ( Uthman, 2009 ) .Research hypothesisIs there any relationship between, kid factors, female parent factors, and family factors with happening of malnutrition in kids under five old ages of age.Research inquiryWhat is the most dominant factor act uponing the happening of malnutrition in kids under five old ages of age?Conceptual ModelChild factors:AgeSexual activityBreastfeedingMothers Factors:AgeEducationOccupationFamily Factors:RearingHouse sanitationChild malnutrition:StuntingWastingUnderweightFigure 1. Thesis program conceptual model adopted from UNICEF ( 1997 )Operational definitionMalnutrition in kids is the kid under five old ages of age who has diagnosed malnutrition by Department of Health in West Nusa Tenggara Province. Child factors are the factor in a kids related to age, sex and chest eating of the kids. Mother factors are the factors related to age, instruction, and business of the female parents in the household. Family factors are the factors related to house sanitation and rearing theoretical account in the household.Chapter IIIMethods and ProceduresMethodologyResearch design Research design in this survey is cross-sectional. A cross-sectional survey is one of the most common and well-known survey designs. In this type of research survey, either the full population or a subset thereof is selected, and from these persons, informations are collected to assist reply the research inquiries. The information that is gathered represents what is traveling on at merely one point in clip ( Ollsen and George, 2004 ) . Population and sample Population in this research is households who have kids under five old ages of age in West Nusa Tenggara Province of Indonesia. The focal point samples are households who have kids under five old ages of age with diagnosed malnutrition in West Nusa Tenggara Province of Indonesia. Sampling technique in this research is utilizing a purposive sample. The sample choice is based on these features: Inclusion Standards Children under five old ages old who live with their household Family who willing to take portion in the survey Family in West Nusa Tenggara Province Sample Size Puting This research will be take topographic point in households at West Nusa Tenggara Province Measurement The anthropometric information of the kids were assessed utilizing the WHO Anthro package version 3.2.2. , to mensurate the informations about kid factors, female parents factors, and family factors will be utilizing inquirers. Because of this instrument used English linguistic communication, the research worker will interpret and so formalize by transcribers who were expert in both the English and Indonesia languages to guarantee equivalence the instrument in Indonesia linguistic communication. The instrument will be test dependability by utilizing with the similar samples, and guarantee that it is applicable with Indonesian people before roll uping informations. Ethical Consideration Ethical blessing should be granted by KU foremost. Then, a permission to make the research at the provincial and territory wellness offices, community wellness centres and voluntary are required. Participant information sheet ( PIS ) , namelessness, confidentiality, and informed concsent will be used to protect sample and the research worker.Plan for informations aggregationThe information about households who have kids under five old ages of age with malnutrition collected from section of wellness in West Nusa Tenggara Province of Indonesia. The anthropometric information of the kids were assessed utilizing the WHO Anthro package version 3.2.2, and expressed as z-scores for each of the anthropometric indices of malnutrition against both the new WHO child growing criterions and the older NCHS/WHO mention. A kid was defined as stunted, scraggy or wasted if his/her height-for-age ( HAZ ) , weight-for-age ( WAZ ) or weight-for-height ( WHZ ) z-score was more than two standard divergence s ( SDs ) below the mention median. Direct interview with a set of questionnaires will be used to roll up informations from the households related with child factors, female parent ‘s factors, and family factors.Plan for informations analysisTo measure factors of malnutrition in kids under five old ages of age utilizing multivariate analysis and was performed utilizing Eview 4.0. Eview provide sophisticated information analysis, arrested development, and prediction tools on a Windows base computing machine. The multivariate analysis will take into history the hierarchal relationships between kid factors, female parent ‘s factors, and family factors with kids malnutrition. There will be calculated utilizing logistic arrested development.A survey budgetNo Items Amount/ figure Estimation Price ( in Rupiah ) 1 Paper A4 70 GSM 5 ream @ 50.000 = 250.000 2 Transcript of inquirer 5 @ 100 @ 100 = 50.000 3 Printer ink 4 colourss @ 40,000 = 160.000 4 Transportation fee 2.500.000 5 Small gift for participant 100 @ 10.000 = 1.000.000 Entire 3.960.000 rupiahTimetableActivity 2012 2013 jun July August September October November December January February March April jun July August September Identify the job Find the relevan literature reappraisal Sum up an analyze the literature Start composing proposal Defense proposal Ask for ethical issues Roll uping informations Analyzing informations Write chapter 4 and 5 Thesis defence Prepare for publication

“The Fall of the House of Usher” and “The Yellow Wallpaper”: A Comparison Introduction

Charlotte Perkins Gilman’s â€Å"The Yellow Wallpaper† has received wide praise for its accurate depiction of madness and the symptoms attributed to mental breakdowns (Shumaker 1985). While these symptoms may seem obvious from today’s psychological perspective, Gilman was writing at the close of the 19th century when the discipline of psychology was still emerging out of a rudimentary psychiatric approach to treating the mentally ill.Though doctors have attempted to write about the treatment of insanity since ancient Greece, the history of madness has most often been characterized by a series of popular images, images that may have stunted the development of a medical model of mental illness: as a wild irrationality, an imaginative and corrupt gothic horror, a violent cruelty that must be confined in asylums, and lastly as a mere nervous disorder.The critic Annette Kolodny suggests that contemporary readers of Gilman’s story most likely learned how to foll ow her fictional representation of mental breakdown by reading the earlier stories of Edgar Allen Poe (Shumaker 1985), and indeed we can locate these strata of historical representations in both â€Å"The Yellow Wallpaper† and Poe’s â€Å"The Fall of the House of Usher.†But where Poe’s depictions seem to confirm negative – and thus not therapeutically useful – stereotypes of madness, Gilman tempers her representations through the emerging psychological model, which allowed her to articulate a new image anticipating the 20th century hope of curing mental diseases through psychological expression. Background Gilman’s story depicts the mental collapse of a late 19th century housewife undergoing the Rest Cure, who grows increasingly obsessed with a disturbing wallpaper pattern.It has been suggested that contemporary readers would have read the story as either a Poe-like study of madness, yet most modern critics focus on a feminist reading in which the wallpaper intentionally represents the â€Å"oppressive patriarchal social system† (Thrailkill 2002). Jane Thrailkill, in her essay about the psychological implications of â€Å"The Yellow Wallpaper,† argues that this feminist reading may actually block the work done by the story to shift 19th century medical conventions surrounding mental illness (Thrailkill 2002).Gilman stated that everything she wrote was for a purpose beyond mere literary entertainment, and that â€Å"The Yellow Wallpaper† was written in order to highlight the dangers of certain medical practices, particularly to convince Weir Mitchell to change the method of his Rest Cure for nervous ailments (which Gilman herself had unsuccessfully undergone) (Shumaker 1985, Thrailkill 2002).In Gilman’s words, the story was, â€Å"†¦intended†¦ to save people from going crazy, and it worked† (Thrailkill 2002). Like Gilman, Poe may also have suffered from mental illness, but following the concerns of his historical moment, Poe seems to have been more interested in the construction of aesthetic effects instead of how those effects might change social and scientific perspectives.The only mention of a cure in Poe’s tale is the â€Å"vague hope† that reading a book will relieve excitement (Poe 2003). Nonetheless, Gilman’s methods of representing madness clearly derive from Poe; they both use an â€Å"inspired manic voice,† unnamed narrators, nervous characters with no diagnosable illness, a rebellious foregrounding of the imagination, and a haunting mood with rational design that has been considered Poe’s signature style (Davison 2004).Published sixty years earlier, Poe’s â€Å"The Fall of the House of Usher† in particular seems to anticipate â€Å"The Yellow Wallpaper† in its manor setting and mad characterizations, and thus can serve as an opening point from which to trace the 19th century trans itions in cultural and scientific representations of madness that culminate in Gilman’s tale. Analysis In â€Å"The Fall of the House of Usher,† an unnamed narrator, visiting his old friend Roderick Usher, attempts to describe Roderick’s madness through both external and internal signs of irrationality.Most immediately, Roderick’s hair is described as â€Å"wild† and of â€Å"Arabesque expression,† which the narrator is unable to connect â€Å"with any simple idea of humanity† (Poe 2003). Similarly, Roderick’s manner strikes the narrator with â€Å"an incoherence – an inconsistency,† and his voice is compared to that of â€Å"the lost drunkard, or the irreclaimable eater of opium† (Poe 2003), all of which mark his social difference as not understandable.After the entombment of his sister, Roderick’s external madness intensifies: he roams with â€Å"unequal, and objectless step,† has a â€Å"m ore ghastly hue† of face, a â€Å"species of mad hilarity in his eyes,† a â€Å"restrained hysteria in his whole demeanor,† and speaks in a â€Å"gibbering murmur† (Poe 2003). But all of these are, as the narrator puts it, â€Å"the mere inexplicable vagaries of madness† (Poe 2003). When it comes to representing the internal process of mental breakdown, Poe (at least in this story) still only describes Roderick’s irrationality from an external and stereotypical position.Roderick describes his condition as a â€Å"deplorable folly† that will force him to â€Å"abandon life and reason,† he is â€Å"enchained by certain superstitious impressions,† and suffers from â€Å"melancholy† and â€Å"hypochondria† (two terms associated with earlier misunderstandings of madness) (Poe 2003). The only time we see the irrational thought process represented is in Roderick’s monologue about entombing his sister alive, which uses dashes, italics, and capitalization to indicate a nervous desperation, as in Poe’s â€Å"The Tell-Tale Heart†.In contrast, Gilman drops almost all of these external and stereotypical descriptions of madness in her story, focusing instead on a faithful rendition of irrational thought processes, in particular the narrator’s growing obsession with the yellow wallpaper. Early in the story, the narrator declares that she’s fond of her room, â€Å"all but that horrid wallpaper,† but within a few pages this statement is turned around; the narrator becomes fond of the room â€Å"perhaps because of the wallpaper.It dwells in my mind so† (236). The wallpaper gradually takes over the narrator’s thought process, breaking into other observations without transition, as when the narrator looks out her window and sees â€Å"a lovely country, full of great elms and velvet meadows. This wallpaper has a kind of sub-pattern†¦Ã¢â‚¬  (235 ). Eventually she â€Å"follows that pattern about by the hour† until there are few passages in the text that are not about the wallpaper (238).As her obsession grows, the narrator becomes paranoid that her husband and stepsister are â€Å"secretly effected by it,† and she’s thus â€Å"determined that nobody shall find [the pattern] out but myself† (239). Despite her original loathing of the wallpaper pattern, by the end of the story the narrator’s obsession is so consuming that she claims, â€Å"I don’t want to leave until I have found it out† (240). Instead of being directly told that the narrator is enchained by her impressions like Roderick Usher, we are more realistically shown those irrational impressions at work in the  mind.Another method for representing irrationality is to cast it against a more rational perspective, which both these stories do. Poe’s narrator, for instance, claims to rationally explain away the oth erwise inexplicable events of â€Å"The Fall of the House of Usher† while documenting Roderick’s breakdown (Gruesser 2004). The house’s peculiar atmosphere â€Å"must have been a dream;† his nervousness is â€Å"due to the bewildering influence of the gloomy furniture;† the storm is â€Å"merely an electrical phenomena† (Poe 2003).And yet the uncertainty of events displayed in this narrative unreliability suggests that the narrator might himself be going mad. After describing Roderick’s wild appearance, the narrator says, â€Å"it was no wonder that his condition terrified – that it effected me,† and begins to feel â€Å"the wild influences of [Roderick’s] own fantastic yet impressive superstitions† (Poe 2003). This inability to rely on his own perceptions causes the narrator to flee aghast when the house collapses, where a more rational or unaffected person might first summon the servants or police (Gruess er 2004).According to John Gruesser, the challenge in Poe’s use of unreliability is that he sets reason in opposition to the supernatural, straddling the Gothic/Fantastic genre where supernatural events are more likely than their rational explanations. This supernatural possibility seems to lessen the question of whether madmen are always delusional or can speak the truth, which becomes central for Gilman’s story. â€Å"The Yellow Wallpaper† also uses a rational perspective in the character of her husband and physician John, who is â€Å"practical in the extreme.He has no patience with faith, an intense horror of superstition† (235). Not only does John explain away the unsettling nature of the house as a draught, but he also attempts to explain away the narrator’s mental illness, calling it â€Å"a temporary nervous depression – a slight hysterical tendency† (234). As we will see, this explanation of madness as merely nerves will beco me a large concern for 19th century discussions on mental illness, and as such comes off as far more scientifically realistic than explaining madness through the supernatural.Gilman also has her narrator attempt to rationalize her own madness, beginning the story with her claim of being â€Å"ordinary people,† and continuing this attempt to rationalize even through her mental deterioration: â€Å"it is getting to be a great effort for me to think straight. Just this nervous weakness I suppose† (238). While this use of unreliable explanations is similar to Poe’s, it reads as more realistic because Gilman frames her story in a way that denies the Gothic discourse of supernatural explanations.Despite its eventual medical ineffectuality, the label of â€Å"nerves† is one of the clearest literary representations of madness attempting to explain or deny its mental character. â€Å"True! – nervous – very, very dreadfully nervous I had been and am; † claims the narrator of Poe’s â€Å"The Tell-Tale Heart,† â€Å"but why will you say that I am mad? † (Poe 2003). The Usher family madness in â€Å"The Fall of the House of Usher† is likewise coded; Roderick attempts to pass off their â€Å"constitutional and†¦ family evil† as a â€Å"mere nervous affection† (Poe 2003).He has an excessive â€Å"nervous agitation†¦ and acute bodily illness,† and â€Å"a morbid acuteness of the senses† that makes most food, garments, odors, light, and sounds intolerable (Poe 2003). Madeline is diagnosed with a â€Å"settled apathy, a gradual wasting away,† because whatever is actually wrong with her â€Å"long baffled the skill of her physicians† (Poe 2003). Whether or not these characters are actually mad, one gets the feeling that the word â€Å"nerves† is used by Poe to explain or make legible the Usher family condition for the mid-19th century reader, ind icating that it may be a biological rather than moral or supernatural disorder.The narrator in â€Å"The Yellow Wallpaper† also articulates her condition as nervousness, but within the late-19th century occlusion of madness as merely nerves, this term seems to indicate less an explanation as much as an excuse or denial of any deeper mental problem. As the narrator says in what is easily read as a flippant tone, â€Å"I never used to be so sensitive, I think it is due to this nervous condition,† and â€Å"of course it is only nervousness† that causes her actions to require a greater effort (235).Though her husband has told the narrator that her nervous case is not serious, she expresses a new dissatisfaction with this diagnoses; â€Å"these nervous troubles are dreadfully depressing† (236). This almost ironic but clearly critical representation of nervous disorders marks a break from Poe’s story, but even more importantly indicates the struggle Gilm an went through in her own life against the American medical industry’s changing view of mental illnesses.Though â€Å"The Yellow Wallpaper† was written to specifically address the Rest Cure, as Thrailkill suggests, the story helped shift the medical paradigm from looking at the patient’s body to listening to their words (Thrailkill 2003). The story is permeated with this desire to talk beyond the traditional psychiatric model: not only is the narrator forbidden to write, but her physician husband only sees her physical improvements of â€Å"flesh and color,† paternally dismissing any of her objections (240).To write, however, is the one thing the narrator consistently feels would make her well; it is a relief to â€Å"say what I feel and think†. Thrailkill offers a reading that Gilman’s narrator at first emulates Mitchell’s physiological approach in looking at the wallpaper, which then shifts to the articulation of a narrative surrou nding the woman in the paper, essentially equating the narrator to a medical text (Thrailkill 2003).We do not need to stretch so far however, as the story is already framed as a diary or journal, that is, it claims to be the expression of a person’s actual experience. Though the narrator has difficulty writing, she continues to write, honestly detailing the thoughts, feelings, and visions attending her mental breakdown in a manner that anticipates the 20th century psychological recognition that madness contains a truthful lucidity (Davison 2004).A mentally unstable person’s journal thus represents exactly the kind of â€Å"irrelevant story† that can cure, and which any sympathetic reader can understand as a valid psychological experience of someone who is no longer seen as socially other or â€Å"mad, bad, and dangerous. † Consequently, while Poe’s â€Å"The Fall of the House of Usher† comes off as simply an entertaining story about some ste reotypical madmen, Gilman’s â€Å"The Yellow Wallpaper† is ultimately a psychologically real portrayal of the subjective experience of someone going mad.